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Potential Denial Of Nuvigil By Insurance; Alternatives ?


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3 replies to this topic

#1 Panacea90

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Posted 12 September 2011 - 02:40 PM

Hey all,

Last month I was prescribed by my pdoc a month supply for Nuvigil but not for any of the listed conditions required for the insurance company that I have for coverage. I have less than a week left of the Nuvigil and I am soon to receive a response from my insurance company or doctor regarding whether or not the Nuvigil prescription is to be approved or denied (Prior Authorization). I was prescribed the nuvigil for excessive daytime sleepiness (EDS) but not for any of the specific criteria on the prescribing requirements for the drug needed for insurance coverage (like sleep apnea, shift work sleep disorder, etc.). To note, I had to pay out of pocket for this medication last month and it cost me $ 400.

What I am wondering is what alternative medications can be prescribed in place of Nuvigil that are much less expensive and are useful for excessive daytime sleepiness, which I still have despite also being on Wellbutrin & Effexor and trying a litany of other potential remedies to no avail. I've heard & read that the next best alternative is the amphetamines or methylphenidates, but I am not so sure about the facts.

Tips/Advice/Facts are appreciated.

#2 lukn4hope

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Posted 12 September 2011 - 05:16 PM

I take 30 mg of Ritalin (methyphenidate) every day. It is on the $4 list at Walmart, and I get 2 months worth of 10 mg tablets for $12. It's actually on the $4 list, but they don't advertise it because it is a controlled substance. It's a shame that the non-controlled alternatives are so over the top expensive.
Disclaimer: I am not a doctor, nor do I play one on TV. The information provided by me is intended purely for entertainment purposes.

#3 lindahurt

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Posted 12 September 2011 - 05:39 PM

The cost of medication is ridiculous when you have to pay out of pocket. You should also ask your doctor for other alternatives.

Lindahurt

Edited by lindahurt, 12 September 2011 - 05:45 PM.

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#4 Sheepwoman

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Posted 16 September 2011 - 07:36 PM

If this medication is working to keep you awake, your doc should be able to write an appeal to your insurance why it has been prescribed and how effective it's been for you. If approved your copay will be high (not $400.) If not approved, call the PPA for assistance. Many pharmaceutical companys have programs for people who can't afford to pay for their meds. Some have free med programs and others have low cost. If there's no program for your med, the PPA may refer you to an online reputable pharmacy that has it at a lower price. I got one of my meds for free from GSK when I reached the max in my prescription plan. There's no way I could afford to pay $600 a month for it (and there were no alternatives.)
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God will give you no more than you can handle. This is all a test to see if you are really ready for the good things that are going to come your way. All this pain is going to come back and make me stronger.-Clarence Clemmons 1942-2011

Everything I know, I know because I love. Leo Tolstoy War and Peace




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